Provider Demographics
NPI:1508613225
Name:SANTELISES, VICTORIA (DC)
Entity type:Individual
Prefix:
First Name:VICTORIA
Middle Name:
Last Name:SANTELISES
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4273 GOLDENHILL DR
Mailing Address - Street 2:
Mailing Address - City:PITTSBURG
Mailing Address - State:CA
Mailing Address - Zip Code:94565-6210
Mailing Address - Country:US
Mailing Address - Phone:925-858-0032
Mailing Address - Fax:
Practice Address - Street 1:380 CIVIC DR STE 200A
Practice Address - Street 2:
Practice Address - City:PLEASANT HILL
Practice Address - State:CA
Practice Address - Zip Code:94523-1958
Practice Address - Country:US
Practice Address - Phone:925-858-0032
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-05-01
Last Update Date:2024-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA36967111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor